Individual
MAE MOON BURKHALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.S.S
Contact information
Practice address
409 NW 11TH ST APT 15, OKLAHOMA CITY, OK 73103-3915
(918) 631-6380
Mailing address
409 NW 11TH ST APT 15, OKLAHOMA CITY, OK 73103-3915
(918) 361-6380
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/08/2017
Last updated
04/08/2017
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